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Unilateral increased visual sensitivity in cluster headache: a cross-sectional study.

Roemer B Brandt1, Victor M Cnossen1, Patty Gg Doesborg1

  • 1Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.

Cephalalgia : an International Journal of Headache
|March 18, 2022
PubMed
Summary

Cluster headache patients experience heightened visual sensitivity during attacks and between them, unlike migraine sufferers. This hypersensitivity is typically unilateral and on the same side as the pain.

Keywords:
Cluster headacheheadachephotophobiaprimary headache disordervisual sensitivity

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Area of Science:

  • Neurology
  • Ophthalmology
  • Pain Medicine

Background:

  • Visual sensitivity, particularly to light and patterns, is a hallmark of migraine.
  • Anecdotal reports suggest similar visual sensitivities in cluster headache, causing diagnostic challenges.
  • The presence and nature of visual hypersensitivity in cluster headache remain under-investigated.

Purpose of the Study:

  • To quantitatively assess visual sensitivity in individuals with cluster headache.
  • To compare visual sensitivity during attacks, between attacks, and between bouts of episodic cluster headache.
  • To differentiate visual sensitivity patterns in cluster headache from those in migraine and healthy controls.

Main Methods:

  • Utilized the validated Leiden Visual Sensitivity Scale (L-VISS) questionnaire.
  • Measured visual sensitivity in episodic and chronic cluster headache patients during ictal and interictal periods.
  • Compared L-VISS scores with data from healthy controls and migraine patients.

Main Results:

  • Cluster headache patients exhibited significantly higher L-VISS scores during attacks compared to interictal periods (p < 0.001).
  • Interictal visual sensitivity in cluster headache was significantly higher than in healthy controls (p < 0.001).
  • Visual hypersensitivity was reported by 91% of cluster headache participants, predominantly unilateral and ipsilateral to the pain.

Conclusions:

  • Cluster headache is characterized by increased ictal and interictal visual sensitivity.
  • Unlike migraine, this visual hypersensitivity in cluster headache is typically unilateral and ipsilateral to the pain side.
  • Findings aid in differentiating cluster headache from migraine and inform diagnostic criteria.